摘要
目的提高临床医生对抗Jo-1抗体阳性多发性肌炎(PM)或皮肌炎(DM)患者肺部受累影像学的认识,提高诊断水平,准确评估预后。方法对四川大学华西医院2007年12月至2013年7月21例抗Jo-1抗体阳性PM/DM患者的临床表现、实验室检查、影像学结果进行回顾性分析。结果抗Jo-1抗体阳性PM/DM患者绝大多数(80.95%)具备典型肺间质性病变表现,胸部影像学主要为磨玻璃影以及网格影;比较抗Jo-1抗体阴性PM/DM患者而言,抗Jo-1抗体阳性患者出现肺间质性病变的几率更高(P<0.05);伴有继发性间质性肺病是PM/DM预后不良的主要危险因素;个别抗Jo-1抗体阳性PM/DM患者会以肺部表现为首发症状,表现形式类似肺炎。结论抗Jo-1抗体阳性PM/DM患者常常并发继发性肺间质病变,多数患者影像学上表现符合间质性肺炎特征,个别表现类似肺炎。提高临床医生对此类疾病的认识,提高诊断水平,有助于判断预后。
Objective To improve the imaging knowledge of lung injury of polymyositis/dermatomyositis（ PM /DM） with anti-Jo-1 antibodies. Methods The medical records of 21 PM /DM patients with anti-Jo-1 antibodies were retrospectively analyzed. The clinical presentation,laboratory data and radiographic results were collected and analyzed. Results 80. 95% of the PM /DM patients with anti-Jo-1antibodies showed chest imaging characteristics of typical interstitial lung disease,such as ground-glass opacities or reticular opacity. The frequency of anti-Jo-1 antibodies positive patients who had interstitial lung disease was higher than those patients without anti-Jo-1 antibodies（ P 〈 0. 05）. Concomitant interstitial lung disease was a major contributor to a poor prognostic outcome of patients with PM /DM. Individual patients with anti-Jo-1 antibodies may show initial symptoms of the lung such as pneumonia. Conclusions PM /DM patients with anti-Jo-1 antibodies are likely to develop interstitial lung disease. Most patients carrying anti-Jo-1 antibodies with interstitial lung disease own typical imaging characteristics of interstitial pneumonia.Improve the ability of clinician to identify this kind of disease which will contribute to evaluate the prognosis of PM /DM patients.
出处
《中国呼吸与危重监护杂志》
CAS
2014年第5期494-498,共5页
Chinese Journal of Respiratory and Critical Care Medicine
基金
国家中医临床研究基地业务建设科研专项(JDZX2012032)
